PayerLogic Denial Management Solutions

The planned implementation of ICD-10 in 2015 brings with it a 700% increase in procedure and diagnostic codes. That means workloads likely will intensify as processes change and staff experience a learning curve. The result? An expected rise in errors and resulting denials—and an increase in negative impacts on provider revenue.

PayerLogic Denial Solutions provides support to overturn clinical, technical and other denials. But we don’t stop there. Our experts help you identify and implement process improvements to prevent future charges from turning into denials and eliminate negative impacts on your bottom line.

Maximize Revenue.

Our aggressive approach yields reimbursement on an average 90% of referred viable claims, increasing your cash flow and letting payers know you are unwilling to accept denials as a routine cost.

Minimize Expenses.

Prevent Future Denials.

We work with you to analyze denials and implement best practices that address root causes, facilitate collaboration across your organization, establish common data sources, and minimize the potential future impact of denials.

Monitor Your Success.

We provide you with precisely targeted data, drilled down to exactly what you need to know about your denials—all available online 24/7/365.

The Human Arc Edge

Since inception, PayerLogic Denial Solutions has:

Secured over $300 million in added reimbursement for clients and significantly reduced the financial burden on their patients.

Detected $50 million in “pre-payments” (accounts thought to be denied but actually paid and sitting in “applied cash”) and reported them to the hospital.

Achieved appeal success rates up to and sometimes beyond 60% for referred denials and greater than 90% of those deemed viable for appeal.

October 9, 2014

Our Purpose

We make a difference.

We serve people by being responsive to their needs and empowering them to improve the quality of their lives. We achieve business success by improving the fiscal health of our clients and partners in the healthcare marketplace and improving access to healthcare and other quality-of-life benefits.